Une forme limite de délire et son rapport au conflit psychique

Abstract

The relation between delirium and psychic conflict is considered from a psycho-analytical angle, using a clinical vignette as a starting point. The patient has a particular form of delirium: he claims a bond with a dead girl, whom he has never met. He was observed during several years in individual psychoanalytic psychodrama. His delirium is first discussed as a symptom. Secondly like his bond with the dead person, his acoustic hallucinations – mocking voices – reflect his difficult relationship with his father, also dead. At a third level, the issue of psychic conflict in psychosis is raised, because of the contradictions in the patient's mental functioning. Thus, the conflict can be located at different levels, as a consequence of splitting, or as a manifestation of instinctual defusion. But above all, the patient's delirium seems to hide an identification conflict. Piera Aulagnier also pointed out the importance of identification difficulties in psychosis. From a metapsychological stance, Freud regarded the conflict between Ego and reality as the characteristic for psychosis. This difference of outlook is treated here as a problem whose solution consists in situating the object on the same side as reality. The conflict with reality thus also becomes a conflict with the object, which is the root cause of the psychotic's identification difficulties.